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Title: Evaluating the emotion regulation of positive mood states among people with bipolar disorder using hierarchical clustering
Authors: Chan, SHW 
Yu, CH, Liu, KHK 
Lau, C 
Fung, AOY 
Tse, S
Issue Date: Sep-2021
Source: World journal of psychiatry, 19 Sept. 2021, v. 11, no. 9, p. 619-634
Abstract: BACKGROUND: People with bipolar disorder (BD) frequently struggle with the recurrence of affective symptoms. However, the interplay between coping mechanism and positive mood state remains under-researched.
AIM: To explore the associations among behavioral approach system (BAS) sensitivity level, coping, and positive mood states among people with BD., METHODS, Using a cross-sectional study design, 90 participants with BD were presented with four BAS-activating life event scenarios and assessed with regard to their BAS trait sensitivity, coping flexibility, and mood states. A hierarchical clustering method was used to identify different groups with different styles of coping. Multiple hierarchical regression analyses were conducted to examine the mediating and moderating roles of different components of coping on mood states.
RESULTS: A three-cluster solution was found to best fit the present data set. The findings showed that a low mass of coping combined with low BAS sensitivity level protects people with BD from detrimentally accentuating mood states when they encounter BAS-activating life events. Moreover, coping flexibility is demonstrated to mediate and moderate the relationships between BAS sensitivity level andmood states. Specifically, subduing the perceived controllability and reducing the use of behavioral-activation/emotion-amplifying coping strategies could help buffer the effect of positive affect.
CONCLUSION: The judicious use of coping in emotion regulation for people with BD when encountering BAS-activating life events was indicated. Practical applications and theoretical implications are highlighted.
Keywords: Bipolar Disorder
Mood Regulation
Cluster Analysis
Coping Style
Positive Emotions
Publisher: Baishideng Publishing Group Co.
Journal: World journal of psychiatry 
EISSN: 2220-3206
DOI: 10.5498/wjp.v11.i9.619
Rights: © The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
The following publication Chan, S. H. W., Yu, C. H., Liu, K. H. K., Lau, C., Fung, A. O. Y., & Tse, S. (2021). Evaluating the emotion regulation of positive mood states among people with bipolar disorder using hierarchical clustering. World Journal of Psychiatry, 11(9), 619 is available at https://doi.org/10.5498/wjp.v11.i9.619.
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